Outline of Alexandra and Miller Essay

Thesis: The essential function of a profession is to satisfy the NEEDS of clients (and not to satisfy their wants and desires). OBLIGATIONS FOLLOW from this essential function.

Fundamental needs are the same for everyone: we have these simply because we are human. BASIC IDEA: X is a fundamental need only if a person who fails to obtain x suffers significant harm by failing to obtain it. For example, nutrition and hydration are fundamental needs.

Other needs become fundamental when they become necessary for participation in a particular society.

How do we distinguish these needs from "mere" desires? We need to sort our goals into needs and desires.

1. Examine the MEANS available for satisfying a goal. Look for transitivity of need.

If x is my goal and y is necessary for x, AND if needing x commits me to needing y, then x is a fundamental need.

If x is my goal and y is necessary for x, but desiring x does not commit me to desiring y, then x is merely desired and not a fundamental need.

2. Transitivity to the second order.

When my REASON to pursue x is that I desire x, AND I will be significantly harmed if I don't get x, and the same would be true not just because of my special circumstances, then I have another reason why I should want it (a second order reason to pursue x). Whenever I should want x in this way, x is a fundamental need.

One test is whether we would regard someone as IRRATIONAL in pursuing x at the expense of y. When pursuing x excludes pursuing y (e.g., buying x deprives you of the money for y), AND one causes oneself significant harm by excluding y, then y is a fundamental need.

 Importance of identifying fundamental needs: it provides moral justification for securing the means to something. If x is a fundamental need and one is morally justified in seeking x, and y is the only reasonable or available means to secure x, then one is also morally justified in securing y. (And if z is needed to secure y, one is morally justified in securing z!)


One's right not to be harmed takes priority over duty not to harm others. (This is why it's right to kill in self defense, but only if the other person will kill you.)

Practical result: If x is a fundamental need, but there is no way to generate equal access to x (so that not everyone can secure x), then those who secure x do no wrong to others who fail to secure x. (However, it does not follow that one can harm others in order to take x away from them. If food is scarce, I can't kill you and take your food simply because I need it, too. But if it's available to both of you and you get it first, you do not wrong the other person by depriving them of it.)

If x is a fundamental need and there is a division of labor so that professionals are needed to secure x (or to avoid harm y), then others are released from any obligation to help secure x for additional persons needing x. EXAMPLE: If we have professional fire fighters and your house is on fire, then my obligation to help you ends once I've called the fire department.

THEREFORE, where professionals are empowered to satisfy fundamental needs, they have a moral obligation to provide services that secure it for everyone else. (Presumably, the obligation ends only if it becomes IMPOSSIBLE to provide sufficient services.)

THEREFORE, professional organizations have an obligation to "foster certain institutional arrangements" for their continued functioning. [The organization cannot limit the supply of professionals so that the need will not be met, and it must take steps to see that social conditions do not arise that will prevent their ability to function.]

Example: Doctors can't provide adequate services for everyone in an epidemic. So if medical doctors are allowed monopoly control of health care, then they have an obligation to take preventive steps to avoid epidemics that would result in their inability to provide health care to everyone.

Example: Professionals must take steps to insure that adequate education is available for adequate numbers of professionals.

THEREFORE every professional must work with others in the profession to foster an appropriate professional community. [No free riders!]

THEREFORE where professional organizations develop to secure fundamental needs, governments MUST provide legal protection to the extent necessary to enable them to function.

A practical concern: People are only human, and "affective attitudes" cannot be counted on to motivate professionals. [The doctor who sets out to help people can't be expected to maintain that attitude at all times.] THEREFORE professional organizations should develop professional standards for minimum performance in the professional roles [spelling out what the profession must do for clients]



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            Last updated Oct. 30, 2011